Individual provider Active NPI

Kathleen Brooks, P.T.

  • Physical Therapist
  • Massapequa, NY
National Provider Identifier
1326269077
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
017838-1 Issued in NY
Practice address
200 Old Sunrise Hwy
Massapequa, NY 11758-5545
Phone
(516) 541-6030
Fax
(516) 541-6031
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 017838-1 NY Primary

Addresses

Primary practice location

200 Old Sunrise Hwy
Massapequa, NY 11758-5545

Mailing address

200 Old Sunrise Hwy
Massapequa, NY 11758-5545
Phone (516) 541-6030

Other identifiers 2

IdentifierTypeStateIssuer
286836OtherNYVYTRA
285715POtherNYHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060330000578 NY Practitioner - Physical Therapist in Private Practice 5597773648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Mercy College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2608 Merrick Rd
Bellmore, NY 11710-5715
Phone (516) 730-2230

44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical Group PC Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jun 1, 2019 Accepting new patients
True North Medical Group PC CurrentSince Jan 1, 2018 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Jun 1, 2019 Accepting new patients

Locations

1728 Sunrise Hwy
Merrick, NY 11566
Phone (516) 992-4568

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

36 Lincoln Ave
Fl 2
Rockville Ctr, NY 11570
Phone (516) 766-2176

45 Crossways Park Dr W
Woodbury, NY 11797
Phone (516) 422-8080

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326269077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OLD SUNRISE HWY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585545",
            "telephone_number": "516-541-6030",
            "fax_number": "516-541-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OLD SUNRISE HWY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585545",
            "telephone_number": "516-541-6030",
            "fax_number": "516-541-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017838-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "286836",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "285715P",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.